In-store clinics grow in Valley as doctors fume - East Valley Tribune: News

In-store clinics grow in Valley as doctors fume

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Posted: Friday, June 29, 2007 6:09 am | Updated: 8:10 pm, Fri Oct 7, 2011.

Retail-based health clinics are sprouting like mushrooms throughout the East Valley, offering diagnoses, immunizations and school physicals for patients who might otherwise be clogging an emergency room or doctor’s office.

But physicians are growing increasingly wary of the newest wave in health care, arguing that “pop-in” medical care is no way to address the myriad problems plaguing the overwhelmed, overpriced system.

In the latest salvo, the American Medical Association this week called for an investigation into whether drug store-based clinics illegally steer patients to the stores’ pharmacies. The nation’s largest doctors’ group also urges stronger regulation of the clinics.

The walk-in clinics, including a dozen or so in Mesa, Scottsdale, Chandler, Gilbert and the rest of the Valley, are staffed by nurse-practitioners who treat common ailments, like pink eye and allergies, and offer immunizations, prescriptions, physicals and some diagnostic testing.

And while doctors agree that the clinics are responding to demand from patients who can’t or won’t wait for appointments at traditional medical settings, they question whether they’re giving adequate care.

“It’s McDonald’s medicine,” said Dr. Susan Wilder, who runs a family practice in Scottsdale. “You get what you pay for.”

Industry giant MinuteClinic, a subsidiary of CVS/pharmacy stores, entered the Phoenix market last year, following the Avondale-based MediMin, with three walk-in clinics inside Bashas’ and Food City, including one in north Scottsdale.

Nationally, there are about 500 retail-based clinics, including alliances with Wal-Mart and Walgreen Co. They’re open nights and weekends, and typically charge $40 to $70 per visit, or an insurance co-pay.

The retail chains dismiss the AMA’s claims and say doctors are just chafed because they’re losing business.

“I think a lot of primary-care physicians out there are feeling threatened,” said Rob Tofil, president and CEO of MediMin. “We’re just competition. And like anybody, they fear competition.”

Tofil said patients can fill their prescriptions anywhere they want, and the clinics are regulated like outpatient centers.

The Arizona Department of Health Services licenses Medi-Min and MinuteClinic under an “unclassified” category that takes in a growing list of other specialties, like lab, X-ray, outpatient and urgent care centers.

MinuteClinic CEO Michael Howe, a former CEO of Arby’s, said the doctors’ group is ignoring reality and seeks to limit patient options.

“We’re extremely disappointed with the action taken by the AMA to maintain the status quo in a healthcare system that is considered by all to be broken,” Howe said in a statement. “We do not believe that the AMA actions address consumers’ need for access to high quality, convenient, affordable care for common ailments.”

Doctors say they’re not worried about losing patients, but rather that the clinics threaten health care on several fronts.

For starters, traipsing contagious children through a grocery store is a public health risk, they say.

And they argue that everyone needs a “medical home” with a physician who knows them and their history. That’s not possible at a drug-store clinic, and they worry that, particularly when it comes to children, critical health problems will be missed.

“These are places with fragmented health care,” said Dr. Mary Rimsza, a longtime Valley pediatrician and executive member of the American Academy of Pediatrics.

“I don’t think it’s sour grapes on the part of physicians,” Rimsza said. “We just don’t think it’s good care.”

But, she said, it’s clear that patients are tired of waiting weeks to get an appointment with their physician, or getting funneled to emergency rooms during off-hours. Doctors need to respond by offering evening and weekend hours, or risk steering patients to the clinics. “I just think it’s another reflection of how broken our health care system is,” she said.

• To read the American Medical Association’s statement about retail clinics, go to www.ama-assn.org/ ama/pub/category/17723.html

• To read the American Academy of Pediatrics’ policy statement on retail clinics, go to http://aappolicy.aappublications.org/cgi/content/full/ pediatrics;118/6/2561

• For locations or more information about MinuteClinic, go to www.minuteclinic.com; for MediMin, go to www.medimin.net.

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